Automated endoscope system for optimal positioning

ABSTRACT

A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

This is a Continuation Application of application Ser. No. 08/613,866,filed Mar. 11, 1996, which is a Continuation Application of applicationSer. No. 08/072,982, filed Jun. 3, 1993, U.S. Pat. No. 5,524,180, whichis a Continuation-in-Part of application Ser. No. 08/005,604, filed Jan.19, 1993, now abandoned, which is a Continuation-in-Part of applicationSer. No. 927,801, filed Aug. 10, 1992, now abandoned.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a robotic system for remotelycontrolling the position of a surgical instrument.

2. Description of Related Art

Endoscopes typically contain a lens that is coupled to a visual displayby a fiber optic cable. Such a system allows the user to remotely viewan image in front of the scope. Endoscopes are commonly used in asurgical procedure known as laparoscopy, which involves inserting theendoscope into the patient through a small incision in the abdomen. Theendoscope allows the surgeon to internally view the patient withoutbeing in a direct line of sight with the object. The use of an endoscopetypically reduces the size of the incision needed to perform a surgicalprocedure.

Endoscopes are commonly used to assist the surgeon in removing the gallbladder of a patient. Because the surgeon typically requires both handsto remove a gall bladder, the endoscope must be held and operated by aassistant. During the surgical procedure, the surgeon must frequentlyinstruct the assistant to move the endoscope within the patient. Such amethod can be time consuming as the surgeon may have to relay a seriesof instructions until the assistant has positioned the endoscope in theproper location. Additionally, the assistant may be unable toconsistently hold the instrument in a fixed position, resulting in amoving image. This is particularly true for surgical procedures thatextend over a long period of time.

There is presently a system marketed by Leonard Medical Inc. whichmechanically holds an endoscope. The Leonard Medical system is anarticulated mechanism which has a plurality of pneumatically poweredjoints that hold the endoscope in a fixed position. To move theendoscope, the pneumatic powered joints must be initially released intoa relaxed condition. The surgeon or assistant then moves the scope andreactivates the pneumatic system. Although the Leonard system holds theendoscope in one position, the system requires the surgeon or assistantto constantly deactivate/activate the pneumatics and manually move thescope. Such a system interrupts the surgery process and increases thetime of the surgical procedure. It would be desirable to provide asystem that allows the surgeon to directly and efficiently control themovement of an endoscope.

SUMMARY OF THE INVENTION

The present invention is a robotic system that moves a surgicalinstrument in response to the actuation of a foot pedal that can beoperated by the foot of a surgeon. The robotic system has an endeffector that is adapted to hold a surgical instrument such as anendoscope. The end effector is coupled to a robotic arm assembly whichcan move the endoscope relative to the patient. The system includes acomputer which controls the movement of the robotic arm in response toinput signals from the foot pedal.

The computer computes the amount of incremental movement required tomove the end effector in accordance with a set of algorithms. Thealgorithms transform the input of the foot pedal so that the movement ofthe endoscope as seen by the surgeon is always in the same direction asthe movement of the foot pedal. Thus when the foot pedal is depressed tomove the endoscope up or down, the end effector is manipulated so thatthe scope always moves relative to the image in an up or down directionas viewed by the surgeon. The robotic system is also moved in accordancewith an algorithm that insures a consistent orientation of the imageviewed by the surgeon.

Therefore it is an object of the present invention to provide a systemwhich allows a surgeon to remotely control the position of a surgicalinstrument.

BRIEF DESCRIPTION OF THE DRAWINGS

The objects and advantages of the present invention will become morereadily apparent to those ordinarily skilled in the art after reviewingthe following detailed description and accompanying drawings, wherein:

FIG. 1 is a side view of a robotic system of the present invention;

FIG. 2 is a top view of the robotic system of FIG. 1;

FIG. 3 is a top view of an end effector used to hold an endoscope;

FIG. 4 is a top view of a foot pedal of the system of FIG. 1;

FIG. 5 is a cross-sectional view of the foot pedal of FIG. 4;

FIG. 6 is a schematic of a computer of the robotic system shown in FIG.1;

FIG. 7 is a schematic of the endoscope oriented in a second coordinatesystem;

FIG. 8 is a flowchart showing the operation of the system;

FIG. 9 is a graph showing the incremental movement of the robotic armassembly;

FIG. 10 is a cross-sectional view of the robotic arm assembly showingactuators coupled to clutch and drive train assemblies;

FIG. 11 is a side view of the system showing a protective sterile bagwhich encapsulates the robotic arm assembly;

FIG. 12 is a cross-sectional view of an alternate embodiment of the endeffector;

FIG. 13 is a perspective view of an alternate embodiment of an endeffector which has a worm gear that is operatively coupled to thesurgical instrument;

FIG. 14 is a perspective view of an alternate embodiment of a roboticsystem which incorporates the worm gear joint of FIG. 13;

FIG. 15 is a schematic of a surgical instrument that defines a thirdcoordinate system located within a fourth fixed coordinate system;

FIG. 16 is a schematic of the surgical instrument being moved relativeto a pivot point.

DETAILED DESCRIPTION OF THE INVENTION

Referring to the drawings more particularly by reference numbers, FIGS.1 and 2 show a robotic system 10 of the present invention. The system 10is typically used in a sterile operating room where a surgeon (notshown) performs a surgical procedure on a patient 12. The patient 12 isplaced on a operating table 14. Attached to the table 14 is a roboticarm assembly 16 which can move a surgical instrument 18 relative to thetable 14 and the patient 12. The surgical instrument 18 is typically anendoscope which is inserted into the abdomen of the patient 12. Theendoscope 18 enters the patient through cannula, wherein the scope 18rotate about a cannula pivot point. The endoscope is typically connectedto a display screen (not shown) which allows the surgeon to view theorgans, etc. of the patient. Although an endoscope is described andshown, it is to be understood that the present invention can be usedwith other surgical instruments.

The system 10 has a computer 20 that is connected to the robotic armassembly 16 and a foot pedal 22. The foot pedal 22 is located in closeproximity to the operating table 14, so that the surgeon can operate thefoot pedal 22 while performing a surgical procedure. The system 10 isconstructed so that the surgeon can move the surgical instrument 18 bymerely depressing the foot pedal 22.

The robotic arm assembly 16 includes a linear actuator 24 fixed to thetable 14. The linear actuator 24 is connected to a linkage arm assembly26 and adapted to move the linkage assembly 26 along the z axis of afirst coordinate system. As shown in FIG. 2, the first coordinate systemalso has an x axis and a y axis. The linear actuator 24 preferably hasan electric motor which turns a ball screw that moves the output shaftof the actuator.

The linkage arm assembly 26 includes a first linkage arm 28 attached toa first rotary actuator 30 and an end effector 32. The first rotaryactuator 30 is adapted to rotate the first linkage arm 28 and endeffector 32 in a plane perpendicular to the z axis (x-y plane). Thefirst rotary actuator 30 is connected to a second rotary actuator 34 bya second linkage arm 36. The second actuator 34 is adapted to rotate thefirst actuator 30 in the x-y plane. The second rotary actuator 34 isconnected to a third rotary actuator 38 by a third linkage arm 40. Thethird rotary actuator 38 is connected to the output shaft of the linearactuator 24 and adapted to rotate the second rotary actuator 34 in thex-y plane. The rotary actuators are preferably electric motors withoutput shafts attached to the respective linkage arms. The actuators 30,34 and 38 preferably have gear reduction boxes to increase the torque atthe linkage arms relative to the electric motors. The electric motors ofthe actuators 24, 30, 34 and 38 rotate in response to output signalsprovided by the computer 20.

As shown in FIG. 3, the end effector 32 has a clamp 42 which can graspand hold the endoscope 18. The clamp 42 may be constructed as a wirewith a loop that has a diameter smaller than the outside diameter of thescope 18. The clamp 42 allows the scope to be easily attached to andremoved from the robotic arm assembly 16. Although a simple wire clampis shown and described, it is to be understood that the end effector 32may have any means required to secure the surgical instrument 18. Asshown in FIGS. 1 and 2, the junction of the endoscope 18 and the endeffector 32 define a second coordinate system which has an x' axis, a y'axis and a z' axis. The junction of the end effector 32 and endoscope 18also define the origin of a third coordinate system which has a x" axis,a y" axis and a z" axis that is parallel with the longitudinal axis ofthe endoscope 18.

The end effector 32 has a shaft 44 which can be coupled to the firstlinkage arm 28. The first linkage arm 28 may have a bearing which allowsthe end effector 32 to rotate about the longitudinal axis of the arm 28.The end effector 32 may be constructed so that the clamp 42 and scope 18can rotate about the y' axis. The end effector 32 is preferablyconstructed to be detached from the first linkage arm 28, so that asterile instrument can be used for each surgical procedure. The roboticsystem 10 may also have a bag or cover to encapsulate the robotic armassembly 16 to keep the assembly 16 sterile.

The actuators 24, 30, 34 and 38 may each have position sensors 46-52that are connected to the computer 20. The sensors may be potentiometersthat can sense the rotational movement of the electric motors andprovide feedback signals to the computer 20. The end effector 32 mayalso have a first joint position sensor 54 that senses the angulardisplacement of the effector about the x' axis and a second jointposition sensor 55 which senses the angular displace of the scope aboutthe y' axis.

FIGS. 4 and 5 show a preferred embodiment of the foot pedal 22. The footpedal 22 has a housing 56 that supports a first foot switch 58 and asecond foot switch 60. The first foot switch 58 has a first pressuretransducer 62 and a second pressure transducer 64. The second footswitch 60 has third 66, fourth 68, fifth 70 and sixth 72 pressuretransducers. The transducers are each connected to a correspondingoperational amplifier that provides a voltage input to the computer 20.The pressure transducers 62-72 are constructed so that the resistance ofeach transducer decreases as the surgeon increases the pressure on thefoot switches. Such a transducer is sold by Interlink Electronics. Thedecreasing transducer resistance increases the input voltage provided tothe computer 20 from the operational amplifier. Each transducercorresponds to a predetermined direction in the third coordinate system.In the preferred embodiment, the first pressure transducer 62corresponds to moving the endoscope toward the image viewed by thesurgeon. The second transducer 64 moves the scope away from the image.The third 66 and fourth 68 transducers move the scope 18 "up" and"down", respectively, and the fifth 70 and sixth 72 transducers move thescope 18 "left" and "right", respectively.

FIG. 6 shows a schematic of the computer 20. The computer 20 has amultiplexer 74 which is connected to the pressure transducers and theposition sensors. In the preferred embodiment, the multiplexer 74 has 12channels, one channel for each sensor and transducer. The multiplexer 74is connected to a single analog to digital (A/D) converter 76.

The computer also has a processor 78 and memory 80. The A/D converter 76is constructed so that the converter can provide the processor 78 with abinary string for each voltage level received from the input signals ofthe system. By way of example, the transducers may provide a voltageranging between -10 to 10 volts (V) and the converter 76 may output adifferent 12 bit binary string for each voltage level. An input signalof 1.0 V may correspond to the binary string 000011001010, 2.0 V maycorrespond to 000111010100 and so forth and so on.

The processor 78 is connected to an address decoder 82 and four separatedigital to analog (D/A) converters 84. Each D/A converter is connectedto an actuator 26, 30, 34 or 38. The D/A converters 84 provide analogoutput signals to the actuators in response to output signals receivedfrom the processor 78. The analog output signals preferably have asufficient voltage level to energize the electric motors and move therobotic arm assembly. The D/A converters 84 may be constructed so that abinary 1 from the processor produces an analog output signal that drivesthe motors. In such an embodiment, the motors are energized for as longas the processor provides a binary 1 output signal. The decoder 82correlates the addresses provided by the processor with a correspondingD/A converter, so that the correct motor(s) is driven. The addressdecoder 82 also provides an address for the input data from the A/Dconverter so that the data is associated with the correct input channel.

The processor 78 computes the movement of the robotic arm assembly 16 inaccordance with the following equations. ##EQU1## where; a2=anglebetween the third linkage arm and the x axis.

a3=angle between the second linkage arm and the longitudinal axis of thethird linkage arm.

a4=angle between the first linkage arm and the longitudinal axis of thesecond linkage arm.

L1=length of the third linkage arm.

L2=length of the second linkage

L3=length of the first linkage arm.

Π=the angle between the first linkage arm and the x' axis of the secondcoordinate system.

x=x coordinate of the end effector in the first coordinate system.

y=y coordinate of the end effector in the first coordinate system. Tomove the end effector to a new location of the x-y plane the processor78 computes the change in angles a2, a3 and a4, and then provides outputsignals to move the actuators accordingly. The original angular positionof the end effector is provided to the processor 78 by the sensors46-55. The processor moves the linkage arms an angle that corresponds tothe difference between the new location and the original location of theend effector. A differential angle Δa2 corresponds to the amount ofangular displacement provided by the third actuator 38, a differentialangle Δa3 corresponds to the amount of angular displacement provided bythe second actuator 34 and a differential angle Δa4 corresponds to theamount of angular displacement provided by the first actuator 30.

To improve the effectiveness of the system 10, the system is constructedso that the movement of the surgical instrument as seen by the surgeon,is always in the same direction as the movement of the foot pedal. Thuswhen the surgeon presses the foot switch to move the scope up, the scopealways appears to move in the up direction. To accomplish this result,the processor 78 converts the desired movement of the end of theendoscope in the third coordinate system to coordinates in the secondcoordinate system, and then converts the coordinates of the secondcoordinate system into the coordinates of the first coordinate system.

The desired movement of the endoscope is converted from the thirdcoordinate system to the second coordinate system by using the followingtransformation matrix; ##EQU2## where; Δx"=the desired incrementalmovement of the scope along the x" axis of the third coordinate system.

Δy"=the desired incremental movement of the scope along the y" axis ofthe third coordinate system.

Δz"=the desired incremental movement of the scope along the z" axis ofthe third coordinate system.

a5=the angle between the z' axis and the scope in the y'-z' plane.

a6=the angle between the z' axis and the scope in the x'-z' plane.

Δx'=the computed incremental movement of the scope along the x' axis ofthe second coordinate system.

Δy'=the computed incremental movement of the scope along the y' axis ofthe second coordinate system.

Δz'=the computed incremental movement of the scope along the z' axis ofthe second coordinate system.

The angles a5 and a6 are provided by the first 54 and second 55 jointposition sensors located on the end effector 32. The angles a5 and a6are shown in FIG. 7.

The desired movement of the endoscope is converted from the secondcoordinate system to the first coordinate system by using the followingtransformation matrix; ##EQU3## where; Δx'=the computed incrementalmovement of the scope along the x' axis of the second coordinate system.

Δy'=the computed incremental movement of the scope along the y' axis ofthe second coordinate system.

Δz'=the computed incremental movement of the scope along the z' axis ofthe second coordinate system.

Π=is the angle between the first linkage arm and the x axis of the firstcoordinate system.

Δx=the computed incremental movement of the scope along the x axis ofthe first coordinate system.

Δy=the computed incremental movement of the scope along the y axis ofthe first coordinate system.

Δz=the computed incremental movement of the scope along the z axis ofthe first coordinate system.

The incremental movements Δx and Δy are inserted into the algorithms (1)described above for computing the angular movements (Δa2, Δa3 and Δa4)of the robotic arm assembly to determine the amount of rotation that isto be provided by each electric motor. The value Δz is used to determinethe amount of linear movement provided by the linear actuator 26.

After each movement of the endoscope a new Π value must be computed tobe used in the next incremental movement of the scope. The scope istypically always in the y'-z' plane, therefore the Π value only changeswhen the end effector is moved along the y' axis. The new Π angle can becomputed with the following equations: ##EQU4## where; d=the length ofthe endoscope between the end effector and the cannula pivot point.

r=the distance along the y' axis between the end effector and thecannula pivot point.

m=the incremental movement of the scope.

The new Π value is computed and stored in the memory of the computer forfurther computation.

FIG. 8 shows a flowchart of a program used to operate the system. Thecomputer 20 initially computes the location of the end effector 32 withthe input provided by the sensors 46-55. When the surgeon presses on oneof the foot switches, the pedal provides a input signal to the computer.For example, the surgeon may want a closer look at an object in front ofthe endoscope. The surgeon then presses the top of the first footswitch, depressing the first transducer and providing an input signal tothe computer. The input signal is converted into an 12 bit binary stringwhich is received by the processor. The 12 bit string corresponds to apredetermined increment of Δz". The computer is constantly sampling thefoot pedal, wherein each sample corresponds to a predetermined incrementin the corresponding axis". If the surgeon holds down the foot pedalduring two sampling periods then the increment to be moved is 2×Δz". Theconverter also provides a multiplication factor for each increase involtage level received from the amplifier of the transducer, so that theincrements are increased for each increase in voltage. Thus the surgeoncan increase the amount of incremental movement by increasing thepressure on the foot switch.

The processor 78 then determines the new coordinates in the thirdcoordinate system. The incremental movements in the third coordinatesystem (Δx", Δy" and Δz") are used to compute the increment movements inthe second coordinate system (Δx', Δy' and Δz') and the coordinates inthe first coordinate system (Δx, Δy and Δz). The incremental movementsare then used to determine the change in the angles a2, a3 and a4, andthe linear movement of actuator 24. The computer provides output signalsto the appropriate electric motors to move the robotic arm assembly tothe new position. The new Π angle is computed and the process isrepeated. The present invention thus allows the surgeon to remotely movea surgical instrument in a manner that directly correlates with theviewing image seen through the endoscope.

In the preferred embodiment, the system moves the end effector 32 sothat the endoscope is always aligned in the same orientation relative tothe patient. This is accomplished by moving the end effector so that theangle a6 is always equal to zero. Thus after each independent movementof the endoscope, the angle a6 is sensed by the sensor 55. If the anglea6 is not equal to zero, the processor moves the end effector inaccordance with the following subroutine.

If a6>zero then the end effector is moved an increment equal to:

    Δπ=π+constant

If a6<zero then the end effector is moved an increment equal to:

    Δπ=π-constant

where;

Δπ=the incremental angular movement of the end effector.

π=the preceding angle π.

constant=some predetermined incremental angular movement of the endeffector.

The processor moves the end effector in accordance with the abovedescribed subroutine until the angle a6 is equal to zero. The new πangle is then stored and used for further computation. Maintaining theangle a6 at zero insures that the view seen by the surgeon is in thesame orientation for all end effector positions.

As shown in FIG. 10, each linkage arm 28, 36 or 80 is preferably coupledto a first helical gear 92. The first helical gear 92 is mated with asecond helical gear 94 that is coupled to an actuator 30, 34 or 38 by aclutch 96. The clutches 96 are preferably constructed from magneticplates that are coupled together when power is supplied to the clutches.When power is terminated, the clutches 96 are disengaged and theactuators are decoupled from the drive shafts such that the linkage armscan be manually moved by the operator. Power is supplied to the clutches96 through a switch 98 which can be operated by the surgeon. Theclutches allow the surgeon to disengage the actuators and manually movethe position of the endoscope.

As shown in FIG. 6, the system may have a lever actuated input device100 that is commonly referred to as a "joystick". The input device 100can be used in the same manner as the foot pedal, wherein the operatorcan move the endoscope by moving the lever 102 of the device 100. Thedevice 100 may also have a plurality of memory buttons 104 that can bemanipulated by the operator. The memory buttons 104 are coupled to theprocessor of the computer. The memory buttons 104 include save buttons106 and recall buttons 108. When the save button 106 is depressed, thecoordinates of the end effector in the first coordinate system are savedin a dedicated addressees) of the computer memory. When a recall button108 is pushed, the processor retrieves the data stored in memory andmoves the end effector to the coordinates of the effector when the savebutton was pushed.

The save memory buttons allow the operator to store the coordinates ofthe end effector in a first position, move the end effector to a secondposition and then return to the first position with the push of abutton. By way of example, the surgeon may take a wide eye view of thepatient from a predetermined location and store the coordinates of thatlocation in memory. Subsequently, the surgeon may manipulate theendoscope to enter cavities, etc. which provide a more narrow view. Thesurgeon can rapidly move back to the wide eye view by merely depressingthe recall button of the system. Additionally, the last position of theendoscope before the depression of the recall button can be stored sothat the surgeon can again return to this position.

As shown in FIG. 9, the system is preferably moved during the recallcycle in a ramping fashion so that there is not any sudden movement ofthe linkage arm assembly. Instead of a purely linear movement of theactuators to move the end effector from point A to point B, theprocessor would preferably move the linkage arm assembly in accordancewith the following equation. ##EQU5## where; t=time

θ₀ =the initial position of the end effector.

θ₁ =the final position of the end effector.

θ₀ =the velocity of the end effector at position θ₀.

θ₁ =the velocity of the end effector at position θ₁.

By moving each actuator in accordance with the above describedalgorithm, the linkage arm assembly movement will gradually increase andthen gradually decrease as the arm leaves and approaches the originaland final positions, respectively. Moving the arm in accordance with theabove described equation produces low initial and final arm accelerationvalues. The gradually increasing and decreasing movement of the armprevents any abrupt or sudden movement of the arm assembly.

As shown in FIG. 11, the robotic arm assembly is preferably encapsulatedby a bag 110. The bag 110 isolates the arm assembly 26 so that the armdoes not contaminate the sterile field of the operating room. The bag110 can be constructed from any material suitable to maintain thesterility of the room. The bag 110 may have fastening means such as ahook and loop material or a zipper which allows the bag to beperiodically removed and replaced after each operating procedure.

FIG. 12 shows an alternate embodiment of an end effector 120. The endeffector-120 has a magnet 122 which holds a metal collar 124 that iscoupled to the endoscope 18. The collar 124 has a center aperture 126which receives the endoscope 18 and a pair of arms 128 which togetherwith screw 130 capture the scope 18. The collar 124 is constructed tofit within a channel 132 located in the end effector 120. The magnet 122is typically strong enough to hold the endoscope during movement of thelinkage arm, yet weak enough to allow the operator to pull the collarand scope away from the end effector.

FIG. 13 shows a preferred embodiment of an end effector 140 that couplesthe surgical instrument 142 to a robotic system 144. The end effector140 has a collar holder 146 which can capture a collar 148 that isattached to the instrument 142. The collar 148 has a lip 150 which isSupported by the base of the collar holder 146 when the instrument 142is coupled to the robotic assembly 144. The collar 148 has a bearing 152that is fastened to the instrument 142 and which has gear teeth 153 thatmesh with a worm gear 154 incorporated into the end effector 140. Theworm gear 154 is typically connected to an electric motor (not shown)which can rotate the gear 154 and spin the instrument 142 about itslongitudinal axis.

The end effector 140 is preferably utilized in a robotic systemschematically shown in FIG. 14. The worm gear replaces the firstactuator 30 of the robotic system shown in FIG. 1. The passive joints156 and 158 allow the same degrees of freedom provided by the passivejoints depicted in FIG. 3. The joints 156 and 158 are shown separatelyfor purposes of clarity, it being understood that the joints may bephysically located within the end effector 140.

The surgical instrument is typically coupled to a camera (not shown) anda viewing screen (not shown) such that any spinning of the instrumentabout its own longitudinal axis will result in a corresponding rotationof the image on the viewing screen. Rotation of the instrument andviewing image may disorient the viewer. It is therefore desirable tomaintain the orientation of the viewing image.

In the embodiment shown in FIG. 1, the robotic assembly moves theinstrument in accordance with a set of algorithms that maintain theangle a6 at a value of zero. This is accomplished by computing a newangle a6 after each movement and then moving the instrument so that a6is equal to zero. Depending upon the location of the end effector,moving the instrument to zero a6 may require energizing some or all ofthe actuators, thus necessitating the computation of the angles a2, a3and a4. Using the worm gear 154 of the end effector 140, the properorientation of the viewing image can be maintained by merely rotatingthe worm gear 154 and scope 142 a calculated angle about thelongitudinal axis of the instrument 142.

AS shown in FIG. 15, the endoscope 142 is oriented within a fixed fourthcoordinate system that has a z axis that is parallel with the z axis ofthe first coordinate system shown in FIG. 1. The origin of the fourthcoordinate system is the intersection of the instrument and the endeffector. For purposes of providing reference points, the instrument isinitially in a first position and moved to a second position. Theendoscope 142 itself defines the third coordinate system, wherein the z"axis coincides with the longitudinal axis of the instrument 142. Toinsure proper orientation of the endoscope 142, the worm ygear 154rotates the instrument 142 about its longitudinal axis an amount Δθ6 toinsure that the y" axis is oriented in the most vertical directionwithin the fixed coordinate system. Δθ6 is computed from the followingcross-products.

    Δθ6=zi"×(yo"×yi")

where;

Δθ6=the angle that the instrument is to be rotated about the z" axis.

yo"=is the vector orientation of the y" axis when the instrument is inthe first position.

yi"=is the vector orientation of the y" axis when the instrument is inthe second position.

zi"=is the vector orientation of the z" axis when the instrument is inthe second position.

The vectors of the yi" and zi" axis are computed with the followingalgorithms. ##EQU6## where; Θ4=is the angle between the instrument andthe z axis in the y-z plane.

Θ5=is the angle between the instrument and the z axis in the x-z plane.

z=is the unit vector of the z axis in the first coordinate system.

The angles Θ4 and Θ5 are provided by the joint position sensors coupledto the joints 156 and 158. The vector yo" is computed using the anglesΘ4 and Θ5 of the instrument in the original or first position. For thecomputation of yi" the angles Θ4 and Θ5 of the second position are usedin the transformation matrix. After each arm movement yo" is set to yi"and a new yi" vector and corresponding Δθ6 angle are computed and usedto re-orient the endoscope. Using the above described algorithms, theworm gear continuously rotates the instrument about its longitudinalaxis to insure that the pivotal movement of the endoscope does not causea corresponding rotation of the viewing image.

When the surgical instrument is initially inserted into the patient theexact location of the pivot point of the instrument is unknown. It isdesirable to compute the pivot point to determine the amount of roboticmovement required to move the lens portion of the scope. Accuratemovement of the end effector and the opposite lens portion of theinstrument can be provided by knowing the pivot point and the distancebetween the pivot point and the end effector. The pivot point locationcan also be used to insure that the base of the instrument is not pushedinto the patient, and to prevent the instrument from being pulled out ofthe patient.

The pivot point of the instrument is calculated by initially determiningthe original position of the intersection of the end effector and theinstrument PO, and the unit vector Uo which has the same orientation asthe instrument. The position P(x, y, z) values can be derived from thevarious position sensors of the robotic assembly described above. Theunit vector Uo is computed by the transformation matrix: ##EQU7##

After each movement of the end effector an angular movement of theinstrument Δθ is computed by taking the arcsin of the cross-product ofthe first and second unit vectors Uo and U1 of the instrument inaccordance with the following line equations Lo and L1.

    Δθ=arc sin (|T|)

    T=Uo×U1

where;

T=a vector which is a cross-product of unit vectors Uo and U1.

The unit vector of the new instrument position U1 is again determinedusing the positions sensors and the transformation matrix describedabove. If the angle Δθ is greater than a threshold value, then a newpivot point is calculated and Uo is set to U1. As shown in FIG. 16, thefirst and second instrument orientations can be defined by the lineequations Lo and L1:

Lo:

    xo=Mx0·Zo+Cxo

    yo=Myo·Zo+Cyo

L1:

    x1=Mx1·Z1+Cx1

    y1=My1·Z1+Cy1

where;

Zo=a Z coordinate along the line Lo relative to the z axis of the firstcoordinate system.

Z1=a Z coordinate along the line L1 relative to the z axis of the firstcoordinate system.

Mxo=a slope of the line Lo as a function of Zo.

Myo=a slope of the line Lo as a function of Zo.

Mx1=a slope of the line L1 as a function of Z1.

My1=a slope of the line L1 as a function of Z1.

Cxo=a constant which represents the intersection of the line Lo and thex axis of the first coordinate system.

Cyo=a constant which represents the intersection of the line Lo and they axis of the first coordinate system.

Cx1=a constant which represents the intersection of the L1 and the xaxis of the first coordinate system.

Cy1=a constant which represents the intersection of the line L1 and they axis of the first coordinate system.

The slopes are computed using the following algorithms:

    Mxo=Uxo/Uzo

    Myo=Uyo/Uzo

    Mx1=Ux1/Uz1

    My1=Uy1/Uz1

    Cx0=Pox-Mx1·Poz

    Cy0=Poy-My1·Poz

    Cx1=P1x-Mx1·P1z

    Cy1=P1y-My1·P1z

where;

Uo(x, y and z)=the unit vectors of the instrument in the first positionwithin the first coordinate system.

U1(x, y and z)=the unit vectors of the instrument in the second positionwithin the first coordinate system.

Po(x, y and z)=the coordinates of the intersection of the end effectorand the instrument in the first position within the first coordinatesystem.

P1(x, y and z)=the coordinates of the intersection of the end effectorand the instrument in the second position within the first coordinatesystem.

To find an approximate pivot point location, the pivot points of theinstrument in the first orientation Lo (pivot point Ro) and in thesecond orientation L1 (pivot point R1) are determined, and the distancehalf way between the two points Ro and R1 is computed and stored as thepivot point R_(ave) of the instrument. The pivot point R_(ave) isdetermined by using the cross-product vector T.

To find the points Ro and R1 the following equalities are set to definea line with the same orientation as the vector T that passes throughboth Lo and L1.

    tx=Tx/Tz

    ty=Ty/Tz

where;

tx=the slope of a line defined by vector T relative to the

Z-x plane of the first coordinate system.

ty=the slope of a line defined by vector T relative to the

Z-y plane of the first coordinate system.

Tx=the x component of the vector T.

Ty=the y component of the vector T.

Tz=the z component of the vector T.

Picking two points to determine the slopes Tx, Ty and Tz (eg. Tx=x1-xo,Ty=yl-yo and Tz=z1-z0) and substituting the line equations Lo and L1,provides a solution for the point coordinates for Ro (xo, yo, zo) and R1(x1, y1, z1) as follows.

    zo=((Mx1-tx)z1+Cx1-Cxo)/(Mxo-tx)

    z1=((Cy1-Cyo)(Mxo-tx)-(Cx1-Cxo)(Myo-ty))/((Myo-ty)(Mx1-tx)-(My1-ty)(Mxo-tx))

    yo=Myo·zo+Cyo

    y1=My1·z1+Cy1

    xo=Mxo·zo+Cxo

    x1=Mx1·z1+Cx1

The average distance between the pivot points Ro and R1 is computed withthe following equation and stored as the pivot point of the instrument.

    R.sub.ave =((x1+xo)/2,(y1+yo)/2,(z1+zo)/2)

The pivot point can be continually updated with the above describedalgorithm routine. Any movement of the pivot point can be compared to athreshold value and a warning signal can be issued or the robotic systemcan become disengaged if the pivot point moves beyond a set limit. Thecomparison with a set limit may be useful in determining whether thepatient is being moved, or the instrument is being manipulated outsideof the patient, situations which may result in injury to the patient orthe occupants of the operating room.

While certain exemplary embodiments have been described and shown in theaccompanying drawings, it is to be understood that such embodiments aremerely illustrative of and not restrictive on the broad invention, andthat this invention not be limited to the specific constructions andarrangements shown and described, since various other modifications mayoccur to those ordinarily skilled in the art.

What is claimed is:
 1. A method for moving an instrument that isinserted into a patient, comprising the steps of:a) attaching theinstrument to an end effector of a robotic arm assembly located within afirst coordinate system having a first x axis, a first y axis and afirst z axis, said robotic arm assembly being adapted to move said endeffector relative to the patient in response to an input command fromthe user, said end effector being located within a second coordinatesystem having a second x axis, a second y axis and a second z axis; b)inserting the instrument into the patient, wherein the instrument islocated within a third coordinate system having a third x axis, a thirdy axis and a third z axis; c) inputting a command to move the instrumenta distance in the third coordinate system; d) computing a movingdistance of the instrument in the second coordinate system from thedistance commanded in step (c); e) computing a moving distance of theinstrument within the first coordinate system from the moving distancecomputed in step (d); and, f) moving said robotic arm assembly until theinstrument has moved the moving distance computed in step (e).
 2. Themethod as recited in claim 1, wherein the moving distance of theinstrument in said second coordinate system is computed in accordancewith the following transformation matrix: ##EQU8## wherein; Δx"=amovement of the end of the instrument along the third x axis;Δy"=anmovement of the end of the instrument along the third y axis; Δz"=anmovement of the end of the instrument along the third z axis; a5=anangle of the instrument and a second x-z plane in the second coordinatesystem; a6=an angle of the instrument and a second y-z plane in thesecond coordinate systems; Δx'=a computed movement of said end effectoralong the second x axis; Δy'=a computed movement of said end effectoralong the second y axis; Δz'=a computed movement of said end effectoralong the second z axis.
 3. The method as recited in claim 2, whereinthe moving distance of the instrument in said first coordinate system iscomputed in accordance with the following transformation matrix:##EQU9## wherein; Δx=a computed movement of said end effector along thefirst x axis;Δy=a computed movement of said end effector along the firsty axis; Δz=a computed movement of said end effector along the first zaxis; Π=a angle between said end effector and the first x axis.
 4. Amethod for moving an instrument that is inserted into a patient,comprising the steps of:a) attaching the instrument to an end effectorof a robotic arm assembly located within a first coordinate systemhaving a first x axis, a first y axis and a first z axis, said roboticarm assembly having an end effector that is located within a secondcoordinate system having a second x axis, a second y axis and a second zaxis, said robotic arm assembly having a first actuator coupled to saidend effector by a first linkage arm, a second actuator coupled to saidfirst actuator by a second linkage arm and a third actuator coupled tosaid second actuator by a third linkage arm, said actuators beingadapted to move said end effector in a plane perpendicular to the firstz axis, said robotic assembly further having a linear actuator coupledto said third actuator to move said third actuator along the first zaxis; b) inserting the instrument into the patient, wherein theinstrument is located within third coordinate system having a third xaxis, a third y axis and a third z axis; c) inputting a command to movethe instrument a distance in the third coordinate system; d) computing amoving distance of the instrument in the second coordinate system fromthe distance commanded in step (c); e) computing a moving distance ofthe instrument within the first coordinate system from the movingdistance computed in step (d); and, f) moving said robotic arm assemblyuntil the instrument has moved the moving distance computed in step (e).5. The method as recited in claim 4, wherein the moving distance of theinstrument in said second coordinate system is computed in accordancewith the following transformation matrix: ##EQU10## wherein Δx"=amovement of the end of the instrument along the third x axis;Δy"=amovement of the end of the instrument along the third y axis; Δz"=amovement of the end of the instrument along the third z axis; a5=anangle of the instrument and a x-y plane in the second coordinate system;a6=an angle of the instrument and a y-z plane in the second coordinatesystem; Δx'=a computed movement of said end effector along the second xaxis; Δy'=a computed movement of said end effector along the second yaxis; Δz'=a computed movement of said end effector along the second zaxis.
 6. The method as recited in claim 5, wherein the moving distanceof the instrument in the first coordinate system is computed inaccordance with the following information matrix: ##EQU11## wherein;Δx=computed movement of said end effector along the first x axis;Δy=acomputed movement of said end effector along the first y axis; Δz=acomputed movement of said end effector along the first z axis; Π=a anglebetween said end effector and the first x axis.
 7. The method as recitedin claim 6, wherein said linear actuator translates said third actuatorΔZ, said third actuator rotates said third linkage arm an angle of Δa2,wherein a2 is computed by the equations; ##EQU12## said second actuatorrotates said second linkage arm an angle Δa3 wherein Δa3 is computed bythe equation; ##EQU13## wherein; L1=is a length of said third linkagearm;L2=is a length of said second linkage arm; L3=is a length of saidthird first arm;and said first actuator rotates said first linkage arman angle Δa4 wherein Δa4 is computed by the equation:

    Δa4=π-Δa2-Δa3.


8. A system that allows a user to control a movement of a surgicalinstrument, wherein the surgical instrument is coupled to a displaydevice that displays an object, comprising:a mechanism that moves thesurgical instrument, said mechanism having an original position; aninput device that receives a command to move the surgical instrument ina desired direction relative to the object displayed by the displaydevice; and, a controller that receives said command to move thesurgical instrument in the desired direction, computes a movement ofsaid mechanism based on said command and the original position of saidmechanism so that the surgical instrument moves in the desireddirection, and provides output signals to said mechanism to move saidmechanism said computed movement to move the surgical instrument in thedesired direction commanded by the user.
 9. The system as recited inclaim 8, wherein said mechanism includes a worm gear adapted to rotate acorresponding bearing member attached to the surgical instrument. 10.The system as recited in claim 9, wherein said mechanism includes acollar attached to the surgical instrument and coupled to a collarholder.
 11. The system as recited in claim 9, wherein said mechanism hasa first joint that allows the surgical instrument to rotate about alongitudinal axis of said first linkage arm and a second joint thatallows the surgical instrument to rotate about an axis that isperpendicular to the longitudinal axis of said first linkage arm. 12.The system as recited in claim 11, wherein said mechanism includes afirst joint sensor that is coupled to the surgical instrument andprovides a first joint feedback signal which corresponds to a firstangular position of the surgical instrument relative to a second x axis,and a second joint sensor that is coupled to the surgical instrument andprovides a second joint feedback signal which corresponds to a secondangular position of the surgical instrument relative to the second yaxis.
 13. The system as recited in claim 8, wherein said mechanismincludes a first linkage arm coupled to the surgical instrument and afirst actuator which can rotate said first linkage arm and the surgicalinstrument in a plane perpendicular to a first z axis, said firstactuator being coupled to a linear actuator which can translate saidfirst actuator along an axis parallel with the first z axis.
 14. Thesystem as recited in claim 13, wherein said mechanism includes a firstactuator sensor that is coupled to said linear actuator and provides afirst feedback signal which corresponds to a location of said firstactuator on the first z axis, and a second actuator sensor that iscoupled to said first actuator for providing a second feedback signalwhich corresponds to a location of the surgical instrument in the planethat is perpendicular to the first z axis.
 15. The system as recited inclaim 14, wherein said mechanism includes a second actuator attached tosaid first actuator by a second linkage arm, said second actuator beingadapted to rotate said first actuator and the surgical instrument in theplane that is perpendicular to the first z axis.
 16. The system asrecited in claim 15, wherein said mechanism includes a third actuatorsensor that is coupled to said second actuator for providing a thirdfeedback signal which corresponds to a location of said first actuatorin the plane that is perpendicular to the first z axis.
 17. The systemas recited in claim 15, further comprising a clutch assembly thatdisengages said first actuator form said linear actuator, said secondactuator from said first actuator and said third actuator from saidsecond actuator when said clutch assembly receives a clutch inputsignal.
 18. The system as recited in claim 15, wherein said first,second and third actuators are electric motors.
 19. The system asrecited in claim 8, wherein said control means is a computer whichreceives input signals from said input means and provides output signalsto said control means to move the position of the surgical instrument.20. The system as recited in claim 19, further comprising storage meansfor storing a first position of said mechanism upon receiving a firststorage input signal and moving said mechanism to said first positionupon receiving a second storage input signal.
 21. The system as recitedin claim 8, wherein said input means includes a foot pedal which can bepressed by the user to generate said input signals.
 22. The system asrecited in claim 8, further comprising a bag that encapsulates saidmechanism.